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From the 9/3/2021 release of VAERS data:

Found 661,087 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 185 out of 6,611

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VAERS ID: 1515214 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-01-25
Onset:2021-07-28
   Days after vaccination:184
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026L20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038K20A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Headache, Paranasal sinus discomfort, SARS-CoV-2 test positive, Sinus congestion
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: sertaline 100 mg qd
Current Illness: no
Preexisting Conditions: no
Allergies: compazine
Diagnostic Lab Data: 7/29/21, positive Covid test
CDC Split Type:

Write-up: I received my first dose listed above on 12/28/20. I received my second dose listed above on 1/25/21. I had little reaction to either dose. However, I started having symptoms including sinus pressure/ congestion and headache and I tested positive for Covid on 7/29/2021, My employer requested that I submit this to you to notify you of the occurrence after being fully vaccinated for several months.


VAERS ID: 1515227 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-07-10
Onset:2021-07-28
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray normal, Chest pain, Diarrhoea, Electrocardiogram normal, Fibrin D dimer normal, Influenza like illness, Metabolic function test, Respiratory tract congestion, Troponin normal, Ventricular extrasystoles
SMQs:, Ventricular tachyarrhythmias (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 500 mg oral tablet aspirin 81 mg oral enteric coated tablet azithromycin (ZITHROMAX) 500 mg oral tablet loperamide (IMMODIUM) 2 mg oral tablet multivitamin Oral Tab nitroGLYCERIN (NITROSTAT) 0.4 mg sublingual ta
Current Illness:
Preexisting Conditions: OSA 1st degree AV block Hx of MI GERD
Allergies: Percocet
Diagnostic Lab Data: EKG July 26 showed AV block (baseline) and PVCs (new) but otherwise reassuring. D dimer negative. Chest xray negative. CMP normal. Troponins normal.
CDC Split Type: None

Write-up: Had 4 days of flu like symptoms directly after receiving the vaccine. These resolved, but some chest congestion remained. Seen in the ER on July 19th for chest pain. Worked up for cardiac and pulmonary causes, all negative. Seen in primary care on July 30 for 2 days of diarrhea, given loperamide and contingent prescription of azithromycin.


VAERS ID: 1515231 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-01-20
Onset:2021-07-28
   Days after vaccination:189
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: EE tested positive to covid 7/28/21


VAERS ID: 1515236 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-26
Onset:2021-07-28
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022C21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cellulitis
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: aspirin 81 mg tablet,delayed release N TAKE ONE TABLET BY MOUTH EVERY DAY gabapentin 300 mg capsule N take 1 capsule by oral route every day losartan 25 mg tablet N take 1 tablet by oral route every day for Discontinue Lisinopril METFORMI
Current Illness: Dm,HTN
Preexisting Conditions: DM HTN
Allergies: KNDA
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: cellulitis left arm


VAERS ID: 1515237 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-24
Onset:2021-07-28
   Days after vaccination:65
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Malaise
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt admitted to the hospital for COVID 19 symptoms post vaccination.


VAERS ID: 1515252 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-07-27
Onset:2021-07-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA74EU / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Injection site induration, Injection site pain, Injection site rash, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: ITP as a child, no complications with it as an adult
Allergies: latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: Got my vaccine on Tuesday evening, by Wednesday evening i had a quarter size red rash around the injection site, by Thursday morning that had more than doubled in size. it is swollen and tender and feels like a knot in it. it was very hot when you touch it. i started taking Benadryl on Wednesday night but size is not changing. taking Tylenol 2x a day as well.


VAERS ID: 1515262 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER 205A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Hypotension, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: UNKNOWN
Preexisting Conditions: UNKNOWN
Allergies: NKA
Diagnostic Lab Data: B/P- 85/62 , retake 90/70 HR- 96 R- 20 O2-96%
CDC Split Type:

Write-up: Within 15 minutes of receiving the vaccine the Pt experienced a brief loss of consciousness while in observation. Upon assessment the Pt was hypotensive all other vitals were WNL. 911 was called and the Pt was transported to the hospital. Pt was conscious during transport.


VAERS ID: 1515269 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-07-27
Onset:2021-07-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Migraine, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine, Eletriptan, Rizatriptan, D-amphetamine salt combo
Current Illness: No illnesses reported
Preexisting Conditions: No chronic health conditions reported
Allergies: Compazine, Sulfa, Codeine, Imitrex
Diagnostic Lab Data: N/A
CDC Split Type: N/A

Write-up: Patient reported getting a rash on her face and a migraine that lasted for two days


VAERS ID: 1515275 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-04
Onset:2021-07-28
   Days after vaccination:146
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9267 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Malaise, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: tested + for COVID, has many symptoms and moderately sick


VAERS ID: 1515281 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Headache, Influenza like illness, Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Not apply
CDC Split Type:

Write-up: 15 year old patient received Janssen vaccine and it''s authorized use is 18 and over. Requested by parent. Follow up call on 7/30 with mom revealed patient had some tiredness, headache and feelings of "fluish" symptoms on 7/29. They resolved by the evening of 7/29 and he was back to normal.


VAERS ID: 1515283 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: Cats Peanuts Pollen Tree nuts
Diagnostic Lab Data:
CDC Split Type:

Write-up: Mother states that patient broke out in hives after vaccination


VAERS ID: 1515285 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-21
Onset:2021-07-28
   Days after vaccination:37
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chest discomfort, Diarrhoea, Dyspnoea, Influenza virus test
SMQs:, Anaphylactic reaction (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: acutain
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: Blood test . flu
CDC Split Type:

Write-up: chest tightness diarrhea shortness of breath


VAERS ID: 1515326 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-07-05
Onset:2021-07-28
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: EE TESTED POSITIVE TO COVID


VAERS ID: 1515364 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, No adverse event
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Benztropine 2mg, Hydroyzine Pam 50mg, Invega Sust 234mg, Paliperidone ER 3mg,
Current Illness: None
Preexisting Conditions: Mental Health
Allergies: Penicillin and Sulfa
Diagnostic Lab Data: THE PATIENT HAD NO ADVERSE EVENT.
CDC Split Type:

Write-up: The patient presented his covid card and only had the 1st dose filled in , He said he needed the second shot. He filled out his paperwork, and it looked good after review , so the vaccination was given. when the technician proceeded billing, the system showed that he had already received 2 doses. However his card was not filled out. I wanted to report because the patient may have received 3 doses of Moderna. I have checked with the patient each day, and he is completely fine AND HE HAS NO ADVERSE EFFFECTS. I just wanted to report this .


VAERS ID: 1515381 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-27
Onset:2021-07-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Numbness (specify: facial area, extremities)-Medium


VAERS ID: 1515388 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Product preparation error
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: none
Preexisting Conditions: TTD
Allergies: PCN
Diagnostic Lab Data:
CDC Split Type:

Write-up: vial of pfizer covid vaccine was diluted with too much diluent.


VAERS ID: 1515399 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-07-26
Onset:2021-07-28
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Echocardiogram normal, Ejection fraction normal, Electrocardiogram abnormal, Myocarditis, Troponin increased
SMQs:, Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: sulfa drugs
Diagnostic Lab Data:
CDC Split Type:

Write-up: Presented with left-sided chest pain 2 days after second dose of vaccine. Remained afebrile. Elevated troponin levels and EKG suggest myopericarditis. Echo showed normal ejection fraction. Received Toradol and aspirin at outside hospital, and then received ibuprofen at ED. He is now stable and under close cardiac monitoring.


VAERS ID: 1515406 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pfizer covid vaccine diluted with too much diluent.


VAERS ID: 1515420 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Incorrect dose administered, Product preparation issue
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: COVID Pfizer diluted with too much diluent.


VAERS ID: 1515427 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: covid Pfizer diluted with too much diluent


VAERS ID: 1515441 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-02-11
Onset:2021-07-28
   Days after vaccination:167
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Lethargy, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Shortness of breath, fever, lethargic, admitted to the hospital on 7/27, discharged 7/29


VAERS ID: 1515461 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-07-27
Onset:2021-07-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Amnesia, Blood test, Chest X-ray, Cyanosis, Dizziness, Dyskinesia, Dyspnoea, Electrocardiogram T wave abnormal, Heart rate decreased, Hypoaesthesia, Hypotension, Loss of consciousness, Muscle spasms, Pregnancy test, Skin discolouration, Tachycardia
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Dyskinesia (narrow), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Other ischaemic heart disease (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: No
Allergies: None known
Diagnostic Lab Data: Blood labs; Chest x ray; Pregnancy test; EKG
CDC Split Type:

Write-up: 16 hours after shot she got dizzy, lightheaded. Passed out on the bathroom floor. Her body then went into muscle spasms her hands and feet crippled up and wouldn''t release. Her body was going numb and she was struggling to breath. Her face was white her lips turned blue. When paramedics arrived her blood pressure was 93/57 her pulse was tachycardia and around 52-59. They were unable to get an IV in her and transported her immediately to local hospital. Where she couldn?t remember much and still had numbness in her body. Her pulse remained low as well as her blood pressure. EKG showed abnormal T waves.


VAERS ID: 1515472 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 066PZIA / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray, Cough, Oropharyngeal pain, Swollen tongue, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: flu numbness in abdomen and les
Other Medications: zyrtec 10 mg citalopram 20 mg pravastatin 20 mg
Current Illness: none
Preexisting Conditions: Asthma
Allergies: Biaxin Amoxicillin Cefaclor Novocain Penicillin Magnevist(Gadopentrates Dimglumine) Gadolinium
Diagnostic Lab Data: Chest X-Ray
CDC Split Type:

Write-up: Throat felt tight Tongue swelling coughing sore throat


VAERS ID: 1515475 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-01-07
Onset:2021-07-28
   Days after vaccination:202
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: WAS TESTED ON 7/28/21, AND TESTED POSITIVE TO COVID.


VAERS ID: 1515478 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Deafness, Dizziness, Loss of consciousness, Skin discolouration, Vision blurred
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: No known drug allergies
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Patient was given vaccine and got up and started walking around the store. She was with her two sisters and after a minute of receiving the vaccine and getting up, she felt dizzy and vision started getting blurry and hearing went out. She passed out on the floor and her sisters caught her. When I arrived to the scene she was sitting up and drinking lemonade but she looked a little gray. After a couple minutes of sitting there she got up and started feeling okay. We did not call paramedics.


VAERS ID: 1515486 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-09
Onset:2021-07-28
   Days after vaccination:110
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / 1 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 3 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, COVID-19, Cough, Diarrhoea, Dizziness, Exposure to SARS-CoV-2, Extra dose administered, Headache, Inappropriate schedule of product administration, Myalgia, Nausea, Oxygen saturation decreased, Pyrexia, SARS-CoV-2 test positive, Sick relative
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Respiratory failure (broad), Tendinopathies and ligament disorders (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amLODIPine Besylate Oral. Vitamin D Oral. Montelukast Sodium Oral. - Meloxicam Oral. EMBREL. traMADol HCl Oral.
Current Illness: Hyperglycemia. Hyperlipidemia. Hypoglycemia. Hypertension. Diabetes Mellitus. Ureterolithiasis. Sepsis (disorder). Respiratory Failure. Nephrolithiasis. Renal Insufficiency/colic
Preexisting Conditions: See above
Allergies: Amitriptyline. DULOXETINE . Lyrica
Diagnostic Lab Data: Covid-19 rapid test done by PCP was reported to be positive on 7/27/21
CDC Split Type:

Write-up: Patient is shown as having received the covid-19 vaccine on 4/9/21, 4/30/21 and on 5/15/21. [This is a 69-year-old female with multiple medical problems who came in with fever , cough, and myalgias x3 days. She also had loss of taste, nausea, diarrhea, h/a,and dizziness., Her husband was found to have Covid. Vitals admission show temperature 99.9, O2 saturation 94% but went down into the 80% with walking, heart rate 103, blood pressure 143/81. She has had the covid vaccine but takes Embrel.


VAERS ID: 1515494 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-07-27
Onset:2021-07-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angioedema, Mouth swelling, Swelling face, Swollen tongue, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Effexor XR, Nexplanon
Current Illness: No
Preexisting Conditions: IgA Nephropathy
Allergies: PCN
Diagnostic Lab Data: No tests performed. No blood work performed.
CDC Split Type:

Write-up: Facial, mouth, tongue swelling (angioedema). Patient went to local Emergency Room, was treated with Prednisone 50mg PO QD x 4 days, Benadryl 25mg Q6 hours x 24 hours & Famotidine PO BID. Symptoms were reduced until the following evening (7/29/2021) when the patient developed significant Hives on her face, head, neck, arms, & chest. She then went back to the local Emergency Room where the Prednisone was increased to 60mg PO QD x 7 days, benadryl increased to 50mg PO Q6 hours & continue with Famotidine BID.


VAERS ID: 1515587 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-07-27
Onset:2021-07-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Hypersomnia, Pain in extremity, Pyrexia, Tenderness
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Pneumonia/ mid 90s
Other Medications: Various medication for chronic conditions
Current Illness: None
Preexisting Conditions: Diabetes, COPD, Emphacima,
Allergies: Egg
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extremely tired (slept most of the next two days after the vaccine), felt like had fever, and had to increase oxygen. Sore arm, very sore to the touch.


VAERS ID: 1515600 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-02-01
Onset:2021-07-28
   Days after vaccination:177
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Work       Purchased by: ?
Symptoms: COVID-19, Feeling cold, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: UNKNOWN
Allergies: NKDA
Diagnostic Lab Data: 072821: Do not have access to COVID-19 test methodology
CDC Split Type:

Write-up: PFIZER COVID-19 EUA: fully vaccinated individual stated that she had allergy-like symptoms on 072721 that were not abnormal to her. She was at work on 072821, and by the end of the workday, she felt "abnormally cold and like she was abnormally crashing". She went to an outside clinic and tested + for covid-19.


VAERS ID: 1515640 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 059E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature increased, Chills, Dehydration, Headache, Heart rate abnormal, Injection site reaction, Lymph node pain, Lymphadenopathy, Muscle twitching, Nausea, Pain, Pain in extremity, Polyuria, Vomiting
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Dyskinesia (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tubulointerstitial diseases (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (narrow), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid
Current Illness: None
Preexisting Conditions: Hypothyroid and mitral valve prolapse
Allergies: Amoxicillin and penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Arm pain and headache shortly after the injection. 5 hours after injection, visible injection site muscle twitching. 12 hours after injection swollen and painful left axcilla lymph nodes with all over body aches especially back and thumbs. 16 hours nausea, wretching, and later vomiting. Dehydration due to vomiting but had inappropriate diuresis. Had to urinate large amounts every 1 to 2 hours. Horrid chills with temp up to 102.9. Abnormal heartbeats. Not irregular or fast just abnormal.


VAERS ID: 1515656 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-07-21
Onset:2021-07-28
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048C21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site mass, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zinc D3 VitC fish oil ibuprofen
Current Illness: None
Preexisting Conditions: Acid reflux
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Red raised lump on arm at injection site , now red ring around injection site , heart palpitations


VAERS ID: 1515660 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: South Dakota  
Vaccinated:2021-07-23
Onset:2021-07-28
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Feeling cold, Headache, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: multivitamin
Current Illness: none
Preexisting Conditions: seasonal allergies
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe body aches, chills, headache, fever up to 103.2 with tylenol on board


VAERS ID: 1515672 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Confusional state, Euphoric mood
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Tetanus, age 6 caused hallucinations
Other Medications: Jardiance, Bystolic, Crestor, Fish oil
Current Illness: None
Preexisting Conditions: Diabetes, High Blood Pressure, High Cholesterol
Allergies: Lisinoprol, codeine, percocet
Diagnostic Lab Data:
CDC Split Type:

Write-up: 2 hours after shot I developed a marijuana high with confusion. This lasted less then 1 hour.


VAERS ID: 1515699 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-27
Onset:2021-07-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Erythema, Headache, Hypertension, Pain, Pruritus, Pyrexia, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Medications at time of vaccination: ferrous sulfate 325mg tab Take 1 tab BID levothyroxine 250mcg PO Daily Other medications have been prescribed but do not have consistent refill hx/ $g1mo overdue for refill: fluticasone nasal spray, lorat
Current Illness:
Preexisting Conditions: PMH: hypothyroidism, DM, Anemia, menorrhagia w/ regular cycle, Obesity, s/p Myomectomy, s/p appendectomy.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: "2 days post vaccination (7/29), pt presents c/o bodyache, headache and feeling low grade fever but did not check temp. Pt also has left arm redness, swelling, and itchiness <9cm in diameter. Vitals: BP 137/90, HR 70, Temp 97.9, SpO2 98%. Pt given a prescription for diphenhydramine and hydroxyzine to be taken as needed QHS. F/u on 7/30 showed HTN BP 148/105, HR 61, RR 18, Temp 97.9, SpO2 100%. HTN possibly medication related or undiagnosed HTN (elevated BPs in the past) but otherwise no change. PMH: hypothyroidism, DM, Anemia, menorrhagia w/ regular cycle, Obesity, s/p Myomectomy, s/p appendectomy. Medications at time of vaccination: ferrous sulfate 325mg tab Take 1 tab BID levothyroxine 250mcg PO Daily Other medications have been prescribed but do not have consistent refill hx/ $g1mo overdue for refill: fluticasone nasal spray, loratadine, Ortho Tri-Cyclen. "


VAERS ID: 1515734 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-07-27
Onset:2021-07-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Pt said her arm was slightly red and swollen around injection site and the reaction has gradually increased in size to about the size of a quarter today.


VAERS ID: 1515738 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired product administered, No adverse event, Product storage error
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness: UNKNOWN
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient received a vaccine that was outside of recommended storage. Vaccine expired at 8:30 pm on the 27th and vaccine was given at 11:43 am on the 28th. Moderna was contacted and stated the patient should watch for signs of infection at the site. Patient called and did not have a reaction at this time.


VAERS ID: 1515741 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: na
Current Illness: na
Preexisting Conditions: na
Allergies: na
Diagnostic Lab Data: na
CDC Split Type:

Write-up: @ 1054 patient reported tingling in left arm, left arm is the arm she had J and J injection in, stated tingling was from lateral pinky finger radiating to elbow area. c/o lightheadedness. denies shortness of breath, headache, fatigue, N/V, no cyanosis noted around lips, injection site without redness or swelling. able to move extremity without pain. v/s checked 98.3, 79, 18, 104/62, spo2 99% on room air. patient stated last meal at 0330, patient accepted 8 ounce bottle of water and had a sandwich with her that she ate. patient education provided for follow up treatment at ER if patient symptoms become worse after leaving site, patient stated understanding. patient continued to sit by this prep nurse for monitoring. 1108 patient stated light headedness has resolved entirely and tingling sensation was diminishing. injection site continues without redness or swelling, denies pain at injection site. continues to deny all other symptoms. 1115 patient stated complete relief of tingling and f/u vital signs 98.3, 86, 18, 112/66, 99% on room air. patient able to raise to standing position without dizziness, patient reeducated on symptoms to monitor for and follow up treatment at ER as needed. stated understanding and released into care of boyfriend.


VAERS ID: 1515750 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: n/a
Preexisting Conditions: none
Allergies: n/a
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Patient had appointment for Covid-19 vaccination. He filled in the form that he has not have any covid vaccine before and we also verbally asked if he has ever has any other Covid vaccine. We proceed the the Pfizer vaccine 1st dose as patient request. At the end of the day, we processed the vaccine through billing insurance. We get a denial for Medicare part B information. We called several times to patient but he had not respond. We checked the immunization website and it showed he already had 2 Pfizer Covid 19 on Jan/25/2021 and 02/18/2021.


VAERS ID: 1515755 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: No adverse event, Product storage error
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unkown
Preexisting Conditions: none reported
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient received a vaccine that was outside of recommended storage. Vaccine expired at 8:30 pm on the 27th and vaccine was given at 11:43 am on the 28th. Moderna was contacted and stated the patient should watch for signs of infection at the site. Patient called and did not have a reaction at this time.


VAERS ID: 1515758 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-15
Onset:2021-07-28
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Angiogram cerebral, Arteriogram carotid, Computerised tomogram head, Facial paralysis, Hemiparesis, Magnetic resonance imaging head
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: hypertension
Allergies: none
Diagnostic Lab Data: Brain MRI x 2 , CT head x 2, CTA head and neck
CDC Split Type:

Write-up: Patient was admitted with 3 seperate episodes of Right sided hemiparesis and right sided facial droop concerning for TIA vs Stroke vs Seizure like episode


VAERS ID: 1515778 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness postural, Headache, Hypotonia, Injection site pain, Nausea
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: na
Current Illness: na
Preexisting Conditions: na
Allergies: na
Diagnostic Lab Data: na
CDC Split Type:

Write-up: 1222 98.3, 58, 18, 120/88, 99% room air, patient began slumping and sliding in chair. nursing staff x 2 assisted patient to floor, patient became more alert in lying position. c/o nausea, headache, denies shortness of breath, denies any other symptoms. no redness, swelling, or pain at the injection site, left arm first dose pfizer. 1225 h20 and 16 ounces, and yogurt coated granola bar for patient, stated last meal 0700. at 1230 nursing staff x 2 assisted patient to standing position to move out of middle of floor, c/o dizziness upon standing. patient sat in chair with feet elevated on another chair. 1232 patient education for symptom monitoring and follow up treatment at ER as needed. EUA factsheet provided. 1252 patient patient still being monitored, laughing, playing on phone, no redness, swelling at injection site, c/o mild pain at injection site, patient described it as a pinch. 1306 reassessed vital signs 98.3,78,18,102/52, 99% room air, denies symptoms, continues to complain about mild pain in left arm at injection site, no redness or swelling noted. patient assisted to standing position denies dizziness. released at this time with guardian.


VAERS ID: 1515921 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-07-27
Onset:2021-07-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Electrocardiogram abnormal, Heart rate irregular, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Anorro
Current Illness: None
Preexisting Conditions: COPD
Allergies: Ginger, Cumin, Ser-Cumin, Tumeric, MSG, Penicillin
Diagnostic Lab Data: EKG
CDC Split Type:

Write-up: Client called and reported she had experienced what felt like her heart jumping approximately 10 hours after receiving vaccination. Reports it felt like her chest wias pounding and it woke her up out of sleep. Client reports this resolved for one day. She is now experiencing these symptoms and having palpitations. Avised client to be seen by medical provider now for these symptoms. Follow-up phone call with client later in day , she reports she went to her PCP and had an EKG, was then sent to ER. Client reports she was told she had early and skipped beats, told to not work tomorrow, increase fluids, and rest. She was not hospitalized. Client will follow-up with PCP.


VAERS ID: 1515933 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Erythema, Petechiae, Pruritus
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient developed a ~3.5 cm erythematous petichiae at the left antecubital fossa approximately 5 minutes after receiving the Pfizer vaccine. Pt admitted to itching; denied tongue swelling, sensation of throat closing, lip swelling. Mom was advised to apply OTC Benadryl cream to area & monitor. Mom advised if tongue/lip swelling, throat closing presents to take patient to ED. Mom expressed understanding of above. Patient was monitored for additional 10 minutes without other adverse event.


VAERS ID: 1515951 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-07-27
Onset:2021-07-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Headache, Influenza like illness, Myalgia, Nausea, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Nortriptyline, fluoxetine, fentanyl 75 MCG patch, oxycodone with Tylenol, Tizanidine, Adderall, Flexeril, Abilify, Lyrica, Eliquis,
Current Illness:
Preexisting Conditions: Lupus, rheumatoid arthritis, Pelvic wall paint, avascular necrosis and hips and shoulder.
Allergies: Soma, PO NSAIDS
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Severe flu like symptoms, fever, chills, nausea, headache, bodyaches, muscle aches.


VAERS ID: 1516199 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vaccine given to minor incorrect type.


VAERS ID: 1516364 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-31
Onset:2021-07-28
   Days after vaccination:119
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Malaise, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: positive covid19 PCR test, 7/29/21
CDC Split Type:

Write-up: fully vaccinated (moderna; 3/3/21, 3/31/21); symptom onset 7/28/21


VAERS ID: 1516525 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal discomfort, Dysgeusia, Ear pruritus, Feeling cold, Hypoaesthesia, Injection site pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Taste and smell disorders (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Latex, penicillin, biaxin, all seafood
Diagnostic Lab Data:
CDC Split Type:

Write-up: 1) Burning sensation at the injection site within 5 minutes of injection (went away about an hour later). 2) Cold, odd/metallic like taste in my mouth about 12 min or so post injection. This lasted for about 6 hours or so. 3) Today, my inner ears started itching like crazy (I have allergies, however this has never happened before) . Still experiencing intermittent inner ear pruritus. 4) Tingling in left arm and numbness/tingling in left leg briefly today. 5) Brief GI discomfort on 7/29 - afternoon 6) Pain at injection site (as expected). Has eased up considerably today.


VAERS ID: 1516744 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Appendicectomy, Chills, Cough, Decreased appetite, Fatigue, Feeling cold, Feeling hot, Headache, Hyperhidrosis, Injection site pain, Lymphadenopathy, Myalgia, Pain, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Day of vaccination: Throbbing and aching muscle pain all over my body, Stabbing pain in my hand on the arm where the injection was received. Very painful injection site. Headache. Loss of appetite. Fatigue. Tylenol and Aleve were taken. Lymph node in armpit was inflamed. Second day: On the second day I experienced the same symptoms that I did on the first day, plus chills. I was extremely cold most of the day, then at night I became extremely hot and began sweating more than usual. Developed a cough. Tylenol and Aleve were taken. Third day: Still have fatigue and muscle pain though not as intense as day one and two. Stabbing pain in my hand on the arm where the injection was received still occurring. Now also getting this stabbing pain in my feet. Headache. Loss of appetite. Fatigue. Lymph node in armpit still inflamed.


VAERS ID: 1517357 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Stomatitis
SMQs:, Severe cutaneous adverse reactions (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Gabapentin, Amount Thyroid, Trazodone; Zyrtec, Singulair, Dulera, Linzess, Priolsec
Current Illness: None
Preexisting Conditions: Chronic neck/back pain; asthma; IBS; Hypothyroidism
Allergies: Codeine
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Sores in mouth


VAERS ID: 1517914 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-01
Onset:2021-07-28
   Days after vaccination:118
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Cough, Rhinorrhoea, Somnolence
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Allergy multiple
Preexisting Conditions: Comments: The patient had a shingles vaccine two weeks ago. It was reported that the patient may have been exposed to positive cases.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210761809

Write-up: RUNNY NOSE; DRY COUGH; TROUBLE WAKING UP; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s height, and weight were not reported. The patient''s concurrent conditions included allergies, and other pre-existing medical conditions included the patient had a shingles vaccine two weeks ago. it was reported that the patient may have been exposed to positive cases. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 28-JUL-2021, the subject experienced runny nose. On 28-JUL-2021, the subject experienced dry cough. On 28-JUL-2021, the subject experienced trouble waking up. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the runny nose, dry cough and trouble waking up was not reported. This report was non-serious.


VAERS ID: 1517922 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, Body temperature, Diarrhoea, Fatigue, Headache, Injection site pain, Muscular weakness, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 virus test positive (COVID-19 back in December (positive test)); Comments: The patient was not pregnant and no breastfeeding at the time of report.
Allergies:
Diagnostic Lab Data: Test Date: 20210729; Test Name: Body temperature; Result Unstructured Data: 100.8 F
CDC Split Type: USJNJFOC20210762984

Write-up: STOMACH PAIN; DIARRHEA; EXTREME MUSCLE WEAKNESS; SEVERE FATIGUE; VERY BAD HEADACHE; FEVER (100.8 F) THAT IS GETTING WORSE; NAUSEA; FELT PAIN AT THE INJECTION SITE; This spontaneous report received from a patient concerned a 27 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included covid-19 positive test, and other pre-existing medical conditions included the patient was not pregnant and no breastfeeding at the time of report. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 206A21A, expiry: UNKNOWN) dose was not reported, administered on 28-JUL-2021 17:45 for prophylactic vaccination. No concomitant medications were reported. On 28-JUL-2021, the subject experienced felt pain at the injection site. On 29-JUL-2021, the subject experienced stomach pain. On 29-JUL-2021, the subject experienced diarrhea. On 29-JUL-2021, the subject experienced extreme muscle weakness. On 29-JUL-2021, the subject experienced severe fatigue. On 29-JUL-2021, the subject experienced very bad headache. On 29-JUL-2021, the subject experienced fever (100.8 f) that is getting worse. On 29-JUL-2021, the subject experienced nausea. Laboratory data included: Body temperature (NR: not provided) 100.8 F. Treatment medications (dates unspecified) included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from felt pain at the injection site, severe fatigue, very bad headache, fever (100.8 f) that is getting worse, extreme muscle weakness, stomach pain, nausea, and diarrhea. This report was non-serious.


VAERS ID: 1517926 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / UNK - / -

Administered by: Military       Purchased by: ?
Symptoms: Chills, Decreased appetite, Discomfort, Feeling abnormal, Hyperhidrosis, Nausea, Pain, Pain in extremity, Salivary hypersecretion
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LISINOPRIL; CHLORTHALIDONE
Current Illness: Alcoholic (2-3 times per week.); Hypertension; Non-smoker
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19; Comments: The patient had no history of drug abuse or illicit drug use.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210763101

Write-up: BODY ACHES; FELT LOOPY; HOT AND COLD SWEATS; LESS OF AN APPETITE; SALIVATING; HOT AND COLD CHILLS; FEELING NAUSEATED; UNCOMFORTABLE; LITTLE SORE ARM; This spontaneous report received from a patient concerned a 55 year old male. The patient''s weight was 220 pounds, and height was 70 inches. The patient''s past medical history included covid-19, and concurrent conditions included hypertension, alcoholic, and non-smoker, and other pre-existing medical conditions included the patient had no history of drug abuse or illicit drug use. The patient experienced rash on foot when treated with oxycodone hydrochloride/paracetamol for drug used for unknown indication. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 204A21A, expiry: UNKNOWN) dose was not reported, administered on 28-JUL-2021 14:58 for prophylactic vaccination. Concomitant medications included chlortalidone for hypertension, and lisinopril for hypertension. On 28-JUL-2021, the subject experienced uncomfortable. On 28-JUL-2021, the subject experienced little sore arm. On 29-JUL-2021, the subject experienced body aches. On 29-JUL-2021, the subject experienced felt loopy. On 29-JUL-2021, the subject experienced hot and cold sweats. On 29-JUL-2021, the subject experienced less of an appetite. On 29-JUL-2021, the subject experienced salivating. On 29-JUL-2021, the subject experienced hot and cold chills. On 29-JUL-2021, the subject experienced feeling nauseated. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from feeling nauseated on 29-JUL-2021, had not recovered from little sore arm, body aches, hot and cold chills, felt loopy, and hot and cold sweats, and the outcome of less of an appetite, salivating and uncomfortable was not reported. This report was non-serious.


VAERS ID: 1517941 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:0000-00-00
Onset:2021-07-28
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Bedridden, Feeling abnormal, Fibromyalgia, Headache, Insomnia, Pain, Pruritus, Skin burning sensation, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Dementia (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Anxiety; Back pain; Bipolar disorder; Blood pressure high; Depression; Fibromyalgia; Insomnia; Migraine; Plantar fasciitis; Sulfonamide allergy
Preexisting Conditions: Medical History/Concurrent Conditions: Hysterectomy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210764078

Write-up: PAIN INTENSIFIED; COULD NOT GET OUT OF BED; SKIN FEELS LIKE BURNING; FEELS LIKE BRAIN NOT WORKING WELL; ITCHY BACK, ARMS AND SKIN; HIVES ON ALL OVER BOTH ARMS BILATERALLY AND POSSIBLE HIVES ON THE BACK; HEADACHE; PAIN THAT FELT LIKE A FIBRAL FLARE /FEELS LIKE WORSE FIBRAL PAIN ALL OVER BODY; COULD NOT SLEEP LAST NIGHT DUE TO THE PAIN; This spontaneous report received from a patient concerned a 44 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included hysterectomy, and concurrent conditions included fibromyalgia, allergic to sulfa drugs, migraines, plantar fasciitis, depression, bipolar disorder, high blood pressure, anxiety, back pain, and insomnia. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 043A21A, expiry: UNKNOWN) dose was not reported, administered on 28-JUL-2021 to left arm for prophylactic vaccination. No concomitant medications were reported. On 28-JUL-2021, the subject experienced pain that felt like a fibral flare /feels like worse fibral pain all over body. On 28-JUL-2021, the subject experienced could not sleep last night due to the pain. On 28-JUL-2021, the subject experienced headache. On 29-JUL-2021, the subject experienced pain intensified. On 29-JUL-2021, the subject experienced could not get out of bed. On 29-JUL-2021, the subject experienced skin feels like burning. On 29-JUL-2021, the subject experienced feels like brain not working well. On 29-JUL-2021, the subject experienced itchy back, arms and skin. On 29-JUL-2021, the subject experienced hives on all over both arms bilaterally and possible hives on the back. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from could not sleep last night due to the pain on 29-JUL-2021, and had not recovered from pain that felt like a fibral flare /feels like worse fibral pain all over body, pain intensified, could not get out of bed, headache, skin feels like burning, hives on all over both arms bilaterally and possible hives on the back, feels like brain not working well, and itchy back, arms and skin. This report was non-serious.


VAERS ID: 1518364 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site mass, Injection site rash, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: No
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pfizer-BioNTech COVID-19 Vaccine EUA Large red swollen rash / lump on arm where injection was given. Starting swelling about 8 hours after injection.


VAERS ID: 1518389 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-27
Onset:2021-07-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053C2LA / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site rash, Migraine
SMQs:, Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies: Pen
Diagnostic Lab Data: na
CDC Split Type:

Write-up: Migraine, and for two - three days after the shot I had a rash where the shot was put into my body.


VAERS ID: 1518398 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Rash
SMQs:, Anaphylactic reaction (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Estradiol 1 mg Progesterone 100 mg
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Not ne
CDC Split Type:

Write-up: Diarrhea - about two hours latter receiving the vaccine Rash around the neck - about 8 hours after receiving the vaccine


VAERS ID: 1518415 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033BZ1A / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Delirium, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: POTASSIUM, PREGABLIN, DEXILANT, TOPIRAMATE, DUTASTERIDE , RANOLAZINE, MYRBETRIQ, MIDODRINE, CLOPIDOGREL , METOPROLOL TARTRATE, LANTUS
Current Illness:
Preexisting Conditions: DIABETES, HEART DISEASE
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reports high fever with delirium and inability to hold a lucid conversation.


VAERS ID: 1518418 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-07-26
Onset:2021-07-28
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Blood test, Chest X-ray, Chest pain, Computerised tomogram, Dizziness, Dyspnoea, Electrocardiogram, Fatigue, Heart rate increased, Injection site erythema, Injection site swelling, Injection site warmth, Palpitations
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 40 mg vyvanse daily
Current Illness: None
Preexisting Conditions: Acid reflux
Allergies: None
Diagnostic Lab Data: Bloodwork, ekg, chest X-ray, CT scan - July 30th
CDC Split Type:

Write-up: Rapid, pounding heart beat. Resting heart rate of 150+ 48 hours after shot. Consistently over 100 bpm for 3 days. Shot was Monday, Was taken by ambulance Wednesday night for chest pain, rapid heart rate, shortness of breath, disoriented. Was monitored and given fluids until heart rate came down. Friday at 1:30 pm ended up back in the ER for chest pain, rapid heart rate, dizziness. Was admitted and received bloodwork, ekg, chest X-ray, CT scan for blood clots. Today is Saturday and rapid heart beat and chest pains still happening. Injection site also still very swollen red and hot to the touch. I feel weak and exhausted.


VAERS ID: 1518422 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO196 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Euphoric mood, Headache, Myalgia, Peripheral swelling, Pharyngeal swelling, Pruritus, Urticaria
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Duloxetine 60mg Wixela 250/50 Trazadone 200mg (bedtime ) Meclizine HCI 25 mg
Current Illness: Osteoarthritis-knee hip back Major Depression Hypothyroidism Etc IBS D Anxiety
Preexisting Conditions: See above plus others
Allergies: All fish and shellfish Bee stings Latex Penicillin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: A major high akin to smoking marijuana; which I never did. I wanted to fly Dizzy Headache Muscle pain on opposite hand w swelling Throat closing up; itching Hives


VAERS ID: 1518426 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: New York  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820096 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired product administered, Product storage error
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: none
CDC Split Type:

Write-up: vaccine was administered when out of recommended storage conditions


VAERS ID: 1518447 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-06-03
Onset:2021-07-28
   Days after vaccination:55
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure abnormal
SMQs:, Neuroleptic malignant syndrome (broad), Hypertension (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfates
Diagnostic Lab Data: None
CDC Split Type:

Write-up: A month after receiving the vaccine I can not regulate my blood pressure I have never had issues with high blood pressure and I am a healthy weight


VAERS ID: 1518460 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Exposure during pregnancy, Lipase normal, Ultrasound abdomen, Vomiting, White blood cell count increased
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness:
Preexisting Conditions:
Allergies: shellfish
Diagnostic Lab Data: WBC 15, lipase 91
CDC Split Type:

Write-up: prior to vaccine no nausea and vomitting. After vaccine has been vomiting last 3 days more than 10 times per day. Found to have elevated lipase/WBC. US showed IUP appropriate for reported being 6 wks pregnant.


VAERS ID: 1518507 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-27
Onset:2021-07-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO180 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Induration, Lymph node pain, Lymphadenopathy, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Woman?s natural transition
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Did not go
CDC Split Type:

Write-up: Severe pain lifting arm on first day. 2nd day extreme pain under left arm. Gland swollen the size of 3/4 of a tennis ball. 3rd day left under arm gland swollen like a tennis ball and feels like a hard boiled egg is inside it. 3rd day gland left side neck is full of jelly like substance. Approximately 3-4 total length about 3/4 inch high. Today is 4th day and both are extremely swollen pain subsiding.


VAERS ID: 1518536 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: muscle soreness


VAERS ID: 1518564 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-03-17
Onset:2021-07-28
   Days after vaccination:133
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7534 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Dyspnoea, Malaise, Pneumonia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness:
Preexisting Conditions: chronic lung disease, obesity
Allergies: unknown
Diagnostic Lab Data:
CDC Split Type:

Write-up: became symptomatic with COVID symptoms on 7/20/2021. Tested (+) on 7/22/2021. Admitted to hospital due to shortness of breath and admitted with diagnosis of pneumonia Discharged two days later on room air and nebulizer


VAERS ID: 1518572 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-22
Onset:2021-07-28
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site rash, Injection site warmth, Rash papular
SMQs:, Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reports swollen large (about 4 inches in diameter) circular raised rash on left arm at injection site. Very warm, as reported by patient. No chills or fever. patient was concerned she had eaten crawfish, but has eaten crawfish in the past with no problems/allergic reactions. Instructed patient to contact provider as soon as possible, and to go to urgent care with any fever or chills or worsening rash. Advised Tylenol and ice packs for now until provider can make sure it is not infected.


VAERS ID: 1518573 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-07-27
Onset:2021-07-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Angina pectoris, Chest pain
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Other ischaemic heart disease (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chest pain/heart pain. I laid on my stomach yesterday and I felt a pain in my heart that I never have before.


VAERS ID: 1518598 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Atrial fibrillation, Dizziness, Headache, Heart rate increased, Oedema peripheral, Somnolence
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: swelling UNDER arm started a few hours after vaccine. Now size of another DD bra cup. Very dizzy. Falling asleep ALOT. Like in the parking lot in my car after a quick trip into grocery shopping. Some afib and high heart (over 135) rate on pulse O2 meter. Mild headache first 48 hours.


VAERS ID: 1518643 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043L20A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Headache, Hypersomnia, Muscle fatigue, Myalgia, Nausea, Pain in extremity, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ginger
Current Illness: None
Preexisting Conditions: None
Allergies: Latex
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Started with a slight headache and nausea on the day of the vaccine followed by sore left arm. That night at about 4:30 am I woke up with a fever and chills which seemed to morph in to just a fever and achy muscles with intense muscle fatigue, dialing a phone was difficult. Continued fatigue and intermittent headache throughout day 2, slept most of the day and through the next night. The following day, Fri the 30th I started to feel a bit better muscles were close to normal other than pain in left arm, fever of 100 degrees (I wasn''t functional enough to check prior to this), head felt odd occasionally like the beginning of a headache. Mostly back to normal by the 31st.


VAERS ID: 1518678 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-08
Onset:2021-07-28
   Days after vaccination:81
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1085029 / UNK - / IM

Administered by: Other       Purchased by: ?
Symptoms: COVID-19 pneumonia, Chest X-ray abnormal, Hypoxia, Intensive care, Lung opacity, SARS-CoV-2 test positive
SMQs:, Asthma/bronchospasm (broad), Interstitial lung disease (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Omeprazole, naproxen
Current Illness: None
Preexisting Conditions: Hyperlipidemia, pre-diabetes, obesity
Allergies: PCN
Diagnostic Lab Data: CXR with bilateral opacities, 7/28 covid pcr positive
CDC Split Type:

Write-up: Admitted to hospital 7/28 for COVID-19 pneumonia, has worsening hypoxia, requiring 100% FiO2 by HFNC. Admitted to ICU 7/30.


VAERS ID: 1518703 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-26
Onset:2021-07-28
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray, Cough, Dyspnoea, Fatigue, Headache, Injection site pain, Nasal congestion, Pain, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu shot years ago
Other Medications: Vitamins
Current Illness:
Preexisting Conditions: Asthma, restless leg syndrome, sleep apnea
Allergies:
Diagnostic Lab Data: Covid test and chest X-rays.
CDC Split Type:

Write-up: Started with aches all over body and pain at the injection site that night after vaccine injection.,Next day had a headache and very tired. Next day after that started coughing and stuffy nose. Next day after that had a hard time breathing so went to ER. Was tested for Covid but negative and chest X-rays taken. ER doc thought I was having an immune response to Covid vaccine and/or viral infection. Gave me a prescription for abutirol and cough medicine and told to drink fluids and rest. Today very congested and coughing and very tired.


VAERS ID: 1518718 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-03-05
Onset:2021-07-28
   Days after vaccination:145
Submitted: 0000-00-00
Entered: 2021-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025A21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood loss anaemia, COVID-19, COVID-19 pneumonia, Condition aggravated, Cough, Gastrointestinal haemorrhage, SARS-CoV-2 test positive, Sickle cell anaemia
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Congenital, familial and genetic disorders (narrow), Gastrointestinal haemorrhage (narrow), Ischaemic colitis (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Acetaminophen, bisacodyl, etodolac, fluoxetine, folic acid, hydroxyurea, magnesium hydroxide
Current Illness: Unknown
Preexisting Conditions: Previous stroke with aphasia, sickle cell anemia, migraine
Allergies: Quinine
Diagnostic Lab Data: PCR COVID test was positive on 7/26/21.
CDC Split Type:

Write-up: Patient received 2 doses of Moderna COVID vaccine on 2/5/21 and 3/5/21 at an outside facility. Patient was admitted to our facility from 7/26/21-7/28/21 for acute GI bleed with anemia due to blood loss (most likely related to COVID-19) in a sickle cell anemia patient, and COVID pneumonia (cough, but never hypoxic).


VAERS ID: 1518771 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-21
Onset:2021-07-28
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / 2 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Arthralgia, Erythema, Loss of personal independence in daily activities, Swelling, X-ray normal
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Dementia (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Had an episode of right first metatarsophalangeal pain, swelling, and slight redness developing shortly after the first of two Moderna injections that resolved after 1 day. Took ibuprofen after onset of pain. No prior occurrences.
Preexisting Conditions: Healthy patient
Allergies: NKDA
Diagnostic Lab Data: Limited lab capabilities. X-ray was normal.
CDC Split Type:

Write-up: Patient developed 3 days of atraumatic right first metatarsophalangeal pain (day 1 of symptoms was 7 days after vaccination), redness, and swelling that improved with ibuprofen. Pain gradually improved but was still lingering at time of encounter.


VAERS ID: 1518780 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-27
Onset:2021-07-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Nausea, Pain, Tachycardia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Body Aches Generalized-Medium, Systemic: Chest Tightness / Heaviness / Pain-Medium, Systemic: Nausea-Medium, Systemic: Tachycardia-Medium


VAERS ID: 1518887 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-06-26
Onset:2021-07-28
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 AR / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall ER (30mg), Wellbutrin XL (300mg)
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Dizziness while sitting. The event only lasts a few seconds per occurrence and occurred 3 - 4 times between 6/28/2021 and 6/30/2021, then again on 8/1/2021.


VAERS ID: 1518900 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-19
Onset:2021-07-28
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0070212 / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Inflammation, Skin indentation, Skin warm, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Carvedilol, Lisinopril, Gabapentin, aspirin, Amiloride, amlodipine, atorevestatin, melatonin
Current Illness: N/A
Preexisting Conditions: Heart disease, hypertrophic cardiomyopathy, kidney disease (liddles syndrome) HTN, tachycardia, left ventricular hypertrophy, diastolic dysfunction.
Allergies: Latex allergy
Diagnostic Lab Data: None yet.
CDC Split Type:

Write-up: Entire arm and shoulder are inflamed, raised, hot to touch, swollen, indented border, and continues to spread throughout remainder of left arm and shoulder.


VAERS ID: 1518982 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004D21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Interchange of vaccine products, No adverse event
SMQs:, Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: antibiotic for tooth abcess
Preexisting Conditions: high blood pressure, not medicated at time of vaccination
Allergies: none
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient received Pfizer COVID vaccine for first dose 7/7/21, was inadvertantly administered Moderna COVID vaccine for second dose. Per CDC guideline no subsequant dose was adminstered. No adverse physical symptoms reported by patient.


VAERS ID: 1519066 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA 6780 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Injection site pain, Malaise, Product preparation issue
SMQs:, Extravasation events (injections, infusions and implants) (broad), Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pain at injection site, general malaise. Due to an incorrectly diluted vial of vaccine. Dose administered was 4X concentrated


VAERS ID: 1519079 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-07-27
Onset:2021-07-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Rash, Rash erythematous, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Topirate
Current Illness: N/A
Preexisting Conditions: Migraines
Allergies: Tigan
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Red itchy rash on the back of my right thigh. It started small, but it is slowly spreading.


VAERS ID: 1519119 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Nausea, Nervousness
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Client reported nausea around 6:35PM. The following was obtained with RN translating. The client was provided an emesis bag. Vitals obtained at 6:40PM were as follows: automatic BP 163/100, HR 91. The client denied any other s/s of anaphylaxis. The client was provided a cotton ball with Peppermint oil on it to smell. Repeat vitals obtained at 06:44PM were as follows: manual BP 160/70, HR 82. The client denied persistent nausea at that time. The client denied any s/s of anaphylaxis at 6:48 PM and stated the nausea was improving. Repeat vitals obtained at 06:54PM were as follows: automatic BP 180/111, HR 82. Repeat manual BP obtained was 165/90. The client denied any s/s of anaphylaxis and stated his nausea resolved at 6:54PM. The client stated that he was feeling nervous today prior to arriving at the vaccination site. The client denied any particular cause for feeling nervous. The client reports a history of anxiety. He states that having his blood pressure taken makes him feel more nervous. Client has no known allergies. The client gets regular vitamin injections, but denies any other chronic medications. The client states he at a burger about one hour ago and has consumed water. The client ambulated unassisted out of the vaccination site at 7:02PM.


VAERS ID: 1519121 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-07-27
Onset:2021-07-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Menstruation irregular, Postpartum haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Fertility disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal Vitamin
Current Illness: Na
Preexisting Conditions: Na
Allergies: Na
Diagnostic Lab Data:
CDC Split Type:

Write-up: Irregular menstrual bleeding. Period at 7 weeks postpartum while exclusively breastfeeding.


VAERS ID: 1519135 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Appendicectomy, Chills, Diarrhoea, Pain, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: N/a
Preexisting Conditions: Asthma
Allergies: N/a
Diagnostic Lab Data:
CDC Split Type:

Write-up: Shortly after the second shot I had terrible body pain and chills. Later that night stabbing pain vomiting and diarrhea. I waited one more day the pain as unbearable and when to the hospital and appendix had to be removed.


VAERS ID: 1519268 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-06-01
Onset:2021-07-28
   Days after vaccination:57
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Blood potassium decreased, Cough, Ear infection, Feeling abnormal, Nasal congestion, Oropharyngeal pain, Pyrexia, Rash, Rash erythematous, Rash pruritic
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypokalaemia (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Oxycodone 5mg/Ibuprofen 400mg.
Current Illness: None
Preexisting Conditions: Broken elbow
Allergies: Aspirin, lisinopril
Diagnostic Lab Data: Low potassium
CDC Split Type:

Write-up: Vax fog, joint pain, nasal congestion, ear infection right ear, cough, fever, red itchy painful bumps, sore throat


VAERS ID: 1519308 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-16
Onset:2021-07-28
   Days after vaccination:134
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016M2014 / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Cough, Diarrhoea, Dyspnoea, Exposure to SARS-CoV-2, Headache, Nausea, Oropharyngeal pain, Rhinorrhoea, Wheezing
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Hypertension, Cardiovascular disease
Allergies: Unknown
Diagnostic Lab Data: This case was not tested but is being treated as a probable case as she is symptomatic and has a household contact who tested positive for Covid 19 and is also symptomatic.
CDC Split Type:

Write-up: Case symptom onset was 7/28/2021 which included runny nose, sore throat, headache, cough, wheezing, shortness of breath, nausea, abdominal pain and diarrhea. As of 7/30/2021 case was still symptomatic.


VAERS ID: 1519475 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Injected limb mobility decreased, Injection site bruising, Injection site pain, Product administered at inappropriate site
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Drug abuse and dependence (broad), Extravasation events (injections, infusions and implants) (broad), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: NKA
Diagnostic Lab Data: She was seen in on 7/30/21. There was a nickel size bruise present high in the deltoid area. She was sent for evaluation at Urgent care on 7/31/21. No testing was done as of this time.
CDC Split Type:

Write-up: Complained of pain, bruising, and inability to raise right arm after receiving the vaccine injection. States it was given too high in the right arm.


VAERS ID: 1519503 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Eye pain, Eye swelling, Fatigue, Headache, Insomnia, Myalgia, Neck pain
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Glaucoma (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vyvanse Motrin or Tylenol
Current Illness: None
Preexisting Conditions: None
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache, body/muscle aches, neck pain, fatigue, insomnia, eye pain & swelling


VAERS ID: 1519517 (history)  
Form: Version 2.0  
Age: 10.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vaccine was incorrectly administered based on patient''s age


VAERS ID: 1519561 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Xeljanz
Current Illness: NONE
Preexisting Conditions: psoriatic arthritis
Allergies: NONE
Diagnostic Lab Data: None.
CDC Split Type: SC202137

Write-up: Client was given an expired dose.


VAERS ID: 1519578 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-27
Onset:2021-07-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Chills, Heart rate increased, Injection site erythema, Injection site pain, Muscle rigidity, Muscle spasms, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Parkinson-like events (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NP Thyroid 60 mg. once daily Metoprolol Tartrate 25 mg. 1/2 pill x 2 daily Eliquis 5 mg. 2 X daily
Current Illness: none
Preexisting Conditions: hypothyroidism periodic A-Fib
Allergies: cephaloxin antibiotic
Diagnostic Lab Data: none
CDC Split Type:

Write-up: violent chills; body rigidity spasms severe joint pain and muscle weakness rapid heart beat. All lasting 9 to 12 hours onset 12 hours after injection. Injection site sore and red after 5 days


VAERS ID: 1519607 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-01-18
Onset:2021-07-28
   Days after vaccination:191
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Tested positive COVID-19 on 7/30/21.


VAERS ID: 1519638 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-02
Onset:2021-07-28
   Days after vaccination:117
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / UNK LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Cough, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 07/28-Cough, suspected fever, chills, body aches


VAERS ID: 1519641 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-01
Onset:2021-07-28
   Days after vaccination:118
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027B21A / UNK RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cough, Oropharyngeal pain, Pyrexia, Sinus congestion, Sinus operation, Sneezing
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: In the last 48 hours, have you had a fever* OR symptoms that are unrelated to a preexisting illness?: New cough, New sore throat (SINUS CONGESTION AND DRAINAGE; SNEEZING)


VAERS ID: 1519653 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-05
Onset:2021-07-28
   Days after vaccination:84
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / UNK LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Exposure to SARS-CoV-2
SMQs:, COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Contact With And (Suspected) Exposure To COVID-19


VAERS ID: 1519664 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 2 LA / ID

Administered by: Senior Living       Purchased by: ?
Symptoms: Chest discomfort, Condition aggravated, Dysphonia, Gait disturbance, Hyperhidrosis, Joint range of motion decreased, Nausea, Neuropathy peripheral, Oedema, Oedema peripheral, Pain, Pain in extremity, Peripheral swelling, Skin warm, Swelling face, Vomiting
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu vaccination last 3 attempts last 2018
Other Medications: Tizanidine 4mg Allegra 10mg Triameterene 75/5mg Hydroxyzine 50mg Synthroid 175mcg Cytomel 5 mg Ergocalciderol 1.25mg Pyridium OTC Lansoprazole 30mg Cymbalta 30 mg Mobic 15 mg Albuterol MDI Simethicone 125 mg Tylenol 650 mg
Current Illness: Nausea and vomiting
Preexisting Conditions: Thyroid Cancer Hashimoto Thyroiditis Interstitial Cystitis Gastroparesis Gerd Fibromyalgia Neuropathy Sinusitis
Allergies: Elavil Chicken Eggs Penicillin Percocet Lobster Catfish Whiting Sesame Apples Oranges Cephalosporins Tinidazole Keppra Topamax Flu vaccination Tetanus vaccination
Diagnostic Lab Data: Appointment tomorrow on 8/3 for followup after emergency treatment Also symptoms are still.present may have to still go to ER
CDC Split Type:

Write-up: Nausea and vomiting within 15 minutes Edema and swelling to bilateral thighs with warmness day 2 L arm pain and swelling with warmness decreased ROM day 1 Neuropathy to entire left side, dragging of left leg day 4 Severe Raspy voice day 3 and 4 symptoms worsen Chest tightness day 3 and 4 symptoms worsen Facial Swelling day 3 and 4 symptoms worsen Body aches and sweating day 2 Treatments included Bendaryl 50 mg Phenergan 12.5 mg Acteminophen 650 mg Decadron 4 mg IM


VAERS ID: 1519688 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-07-14
Onset:2021-07-28
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood urine present, Chromaturia, Protein urine present, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Chronic kidney disease (broad), Proteinuria (narrow), Tubulointerstitial diseases (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D
Current Illness: no
Preexisting Conditions: hematuria
Allergies: no
Diagnostic Lab Data: went to the lab on the 29th . test showed Blood and protein in urine. will have follow up with doctor
CDC Split Type:

Write-up: july 28th fever 10. urine was dark . on the 29th urine was brown .


VAERS ID: 1519733 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-06-21
Onset:2021-07-28
   Days after vaccination:37
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / 1 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: COVID-19, Cough, Dyspnoea, Headache, Malaise, Nausea, Pain, Pyrexia, SARS-CoV-2 test positive, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlodipine, losartan, hydrochlorothiazide
Current Illness: None
Preexisting Conditions: High Blood Pressure
Allergies: None
Diagnostic Lab Data: PCR test done on 7.28.21 followed by a rapid test on 7.29.21. Rapid test was positive on 7.29.21 followed by positive results for PCR on 8.2.21.
CDC Split Type:

Write-up: On 7/28/21, employee began feeling sick. Symptoms were, nauseous, vomiting, headache, fever, body aches, coughing, shortness breath. OTC medications are being taken. No doctor or hospitalization to date.


VAERS ID: 1519825 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-07-19
Onset:2021-07-28
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004D21A / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Amnesia, Feeling abnormal, Memory impairment
SMQs:, Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: metformin, gluposide, metropulple
Current Illness:
Preexisting Conditions: diabetes
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: memory loss, forgetting how to do things, brain fog


VAERS ID: 1519863 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Pharyngeal swelling, Swollen tongue, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall XR 20MG- take 2 capsules daily Anusol-HC 25mg rectal suppository- insert one suppository per rectum BID PRN X 2 weeks Cyanocobalamin 1000mcg/ML- inject 1 ML once a week X 1 month Esomeprazole Magnesium 40mg- 1 capsule daily Levothy
Current Illness: none per patient
Preexisting Conditions: GERD Anxiety Vitamin B12 deficiency Hypothyroidism Vitamin D deficiency ADHD
Allergies: Latex GLP1
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient states she had swelling of her tongue and throat that started approximately 2-4 hours after she received the injection. She states she took a Benadryl and the next day took an antihistamine and was better. Reaction was not severe enough to cause SOB or any visit to a medical facility.


VAERS ID: 1519920 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-10
Onset:2021-07-28
   Days after vaccination:109
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, COVID-19, Chills, Hyperhidrosis, Nasal congestion, Pain, Paranasal sinus discomfort, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: covid test on 7/29 with positive result 7/31
CDC Split Type:

Write-up: No direct adverse reaction to the vaccine itself; however, I was diagnosed with covid on Sunday July 31st 2021. Symptoms from covid included: running/stuffy nose, nasal pressure, chills and sweats, low grade fever, achiness, weak


VAERS ID: 1519974 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-11
Onset:2021-07-28
   Days after vaccination:139
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Dyspnoea, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Presented to hospital with fever, weakness, mild SOB. Requiring oxygen.


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